title: Periprocedural aspects in mechanical recanalization for acute stroke: data from the ENDOSTROKE registry.
abstract: BACKGROUND
  The ENDOSTROKE registry aims to accompany the spreading use of endovascular stroke treatment (EVT) in academic and non-academic hospitals. This analysis focuses on preprocedural imaging, patient handling and referral, as well as on different treatment modalities in mechanical recanalization.
  
  
  METHODS
  Data for this study were from observational registry study in 12 stroke centers in Germany and Austria with online assessment of prespecified variables concerning endovascular stroke therapy.
  
  
  RESULTS
  Data from 734 patients undergoing EVT were analyzed. Preferred imaging modality prior to EVT was CT (83 %) and CTA (78 %). In 95 %, EVT was performed under general anesthesia. In 55 % of patients, a combination of intravenous (IV) thrombolysis and EVT was used, followed by pure EVT (25 %), intra-arterial (IA) thrombolysis plus EVT (13 %) and IV + IA thrombolysis plus EVT (7 %). Intrahospital time delay until start of EVT was 91 and 99 min in anterior and vertebrobasilar circulation stroke, respectively. Average duration of EVT was 60 min. Overall thrombolysis in myocardial infarction grade 2/3 recanalization rate was 85 %. Stent retrievers were used in 75 %, being associated with higher recanalization rates than non-stent retrievers. Hemorrhagic complications (symptomatic and asymptomatic) occurred in 12 %. Overall vessel occlusion time was approximately 60 min longer in patients being referred from a primary care hospital for EVT.
  
  
  CONCLUSIONS
  This study gives an overview of procedure-related factors in current EVT practice. It gives estimates on preprocedural imaging modalities, periprocedural handling, and treatment combinations used for EVT. Patient referral for EVT from primary care hospitals is associated with longer vessel occlusion times.
authors.affiliation: Department of Neurology, Goethe University, Schleusenweg 2-16, 60528, Frankfurt/Main, Germany. o.singer@em.uni-frankfurt.de
authors.forename: Oliver C
authors.initials: OC
authors.lastname: Singer
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Haring
authors.forename: Johannes
authors.initials: J
authors.lastname: Trenkler
authors.forename: Christian H
authors.initials: CH
authors.lastname: Nolte
authors.forename: Georg
authors.initials: G
authors.lastname: Bohner
authors.forename: Tobias
authors.initials: T
authors.lastname: Neumann-Haefelin
authors.forename: Erich
authors.initials: E
authors.lastname: Hofmann
authors.forename: Arno
authors.initials: A
authors.lastname: Reich
authors.forename: Martin
authors.initials: M
authors.lastname: Wiesmann
authors.forename: Kurt
authors.initials: K
authors.lastname: Niederkorn
authors.forename: Hannes
authors.initials: H
authors.lastname: Deutschmann
authors.forename: Matthias
authors.initials: M
authors.lastname: Bussmeyer
authors.forename: Anastasios
authors.initials: A
authors.lastname: Mpotsaris
authors.forename: Anett
authors.initials: A
authors.lastname: Stoll
authors.forename: Albrecht
authors.initials: A
authors.lastname: Bormann
authors.forename: Gabor C
authors.initials: GC
authors.lastname: Petzold
authors.forename: Horst
authors.initials: H
authors.lastname: Urbach
authors.forename: Sebastian
authors.initials: S
authors.lastname: Jander
authors.forename: Bernd
authors.initials: B
authors.lastname: Turowski
authors.forename: Christian
authors.initials: C
authors.lastname: Weimar
authors.forename: Marc
authors.initials: M
authors.lastname: Schlamann
authors.forename: Klaus
authors.initials: K
authors.lastname: Gröschel
authors.forename: Stephan
authors.initials: S
authors.lastname: Boor
authors.forename: Joachim
authors.initials: J
authors.lastname: Berkefeld
mesh_terms: D000368:Aged; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000706:statistics & numerical data*; D008875:Middle Aged; D061646:Operative Time; D019990:Perioperative Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011859:Radiography; D012042:Registries; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D020521:Stroke / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome